Editorial

Expiration date nearing on miracle drugs

Antibiotic use must be regulated before resistant bacteria render them worthless.

An illustration of carbapenem-resistant Enterobacteriaceae, a group… (Centers for Disease Control…)

Beware of magical discoveries: They generally require careful use lest the magic wear off. Even the genie's lamp gave only three wishes.

Antibiotics, which at one point were viewed as miracle drugs providing cures for previously fatal illnesses, are among the discoveries that have been used too carelessly, giving rise to an era of resistant infections. Scientists have been concerned about these resistant bacteria —methicillin-resistant Staphylococcus aureus, or MRSA, is probably the most familiar — for many years. But doctors have continued to prescribe antibiotics unnecessarily for illnesses such as colds that are caused by viruses, not bacteria.

So the report on resistant infections released last week by the national Centers for Disease Control and Prevention didn't reveal startling new information as much is it solidified understanding of the toll taken by these infections in illness, death and dollars. It should serve as a wake-up call to the medical profession, and especially to Congress, to move more swiftly and decisively to preserve the usefulness of antibiotics.

The livestock industry alone consumes some 80% of the antibiotics in this country — not to treat illness in the animals but to promote growth and prevent infections from sweeping through crowded pens. The agriculture lobby has been fierce in its fight to keep using as much of these drugs as it wants, for whatever purposes. It's true that antibiotics help produce food more cheaply. But society as a whole is picking up the large and growing tab in the form of resistant bacteria. The tally according to the CDC report: 2 million Americans sickened each year, 23,000 deaths, $23 billion a year in added medical costs and $35 billion in lost productivity. And the numbers are expected to worsen.

The Food and Drug Administration is offering only guidelines for the agriculture industry, not regulations, and experience has shown that the industry does not respond to voluntary restrictions. Congress, which has rejected more stringent rules on antibiotic use for more than a decade, must act while most antibiotics still retain their power to cure. Medical associations should be convening to draw up new protocols for antibiotic use.

The National Institutes of Health should be looking beyond the antibiotic era to fund research and development of non-antibiotic treatments. Though MRSA gets the headlines, Clostridium difficile was named in the CDC report as the bacterium responsible for the majority of U.S. deaths from resistant bacteria. Research is finding that a technique called fecal transplant — transferring gut bacteria that fight C. difficile from a healthy person to a patient — has a remarkably high success rate. The key to keeping antibiotics useful for a long time is, contradictorily, to avoid using them as much as possible.